1,720,970 research outputs found
Socio-economic differences in factors associated with alcohol use among adolescents in Slovenia: a cross-sectional study
Full text linkObjectives: This paper aims to investigate the association of parental, friends, and personal factors with the risk of alcohol use in a sample of Slovenian adolescents, and whether these associations differ by socio-economic status of the school area (SES). Methods: The survey involved 2946 students of 44 Slovenian primary schools in the school year 2010/2011. The association between sociodemographic characteristics, parental alcohol use and permissiveness to drink, parental monitoring, perception of friends' alcohol use, beliefs towards alcohol, self-esteem and refusal skills, and the probability of recent alcohol use was evaluated through multiple multilevel logistic regression analysis. Results: Parental alcohol use, parental permissiveness to drink alcohol, low parental monitoring, perception of friends’ alcohol use, positive beliefs towards alcohol use, and low refusal skills were significantly associated with the risk of alcohol use. Parental drinking and permissive attitudes were stronger correlates of alcohol use among adolescents of middle and low SES schools, while friends’ alcohol use and personal factors among adolescents of high SES schools. Conclusions: Alcohol prevention programs should be tailored to school socio-economic environment taking into account friends and personal determinants among high SES, and parental factors among low SES school students
Differenze regionali nella mortalità da Overdose e possibili spiegazioni
No full textIntroduzione. La mortalità da overdose in Italia è caratterizzata da una elevata variabilità inter-regionale. A partire dalla fine degli anni ’80 si è inoltre osservato un generale innalzamento dei tassi di mortalità con due picchi, il primo nel 1990 e il secondo nel 1996. I picchi si sono verificati nella maggior parte delle regioni ma con entità molto differente.
Obiettivi. L’obiettivo di questo lavoro è analizzare le possibili cause della variabilità inter-regionale nella mortalità per overdose.
Metodi. Sono state ipotizzate le seguenti cause: 1) variabilità della purezza della sostanza sul mercato; 2) diversa prevalenza di tossicodipendenti; 3) diversa prevalenza di poliuso di sostanze; 4) variabilità nei trattamenti somministrati. I tassi di mortalità da overdose sono stati stimati a partire dai dati del Registro Generale di Mortalità dell’Istat. I dati sulla prevalenza di tossicodipendenti da eroina e sulle tipologie di trattamento erogate sono stati reperiti dai flussi Ministeriali e dalle relazioni al Parlamento sulle tossicodipendenze. Per studiare la purezza della sostanza sul mercato sono state cercate informazioni ad hoc.
Risultati. Il tasso di mortalità standardizzato nel primo picco del 1990 è di circa 2,0/100.000 abitanti in Italia, mentre è compreso tra 3,0 e 3,7/100.000 in Piemonte, Lombardia, Liguria e Lazio. Il secondo picco è di entità simile al primo in Piemonte, mentre è inferiore ma sempre più elevato della media italiana in Lombardia, Lazio, Umbria ed Emilia. Il numero di nuovi utenti SerT, utilizzato come indicatore delle dimensioni dell’andamento del fenomeno tossicodipendenza, non appare essere diverso nelle regioni a più alto tasso di mortalità rispetto alla media Nazionale e alle altre regioni, così come la proporzione di poliusatori. I trattamenti erogati mostrano al contrario ampie differenze tra le regioni nel periodo considerato, ed in particolare il metadone a lungo termine.
Conclusioni. Il numero di nuovi utenti SerT, e la prevalenza di poliusatori mostrano un andamento simile nelle diverse regioni. Le differenze nei trattamenti somministrati sembrano poter spiegare parte della variabilità inter-regionale nella mortalità da overdose. Il ruolo della purezza della sostanza sulle differenze osservate è difficile da definire a causa della scarsità d’informazioni disponibili a tal proposito
The theoretical model of the school-based prevention programme Unplugged
Full text linkUnplugged is a school-based prevention programme designed and tested in the EU-Dap trial. The programme consists of 12 units delivered by class teachers to adolescents 12-14 years old. It is a strongly interactive programme including a training of personal and social skills with a specific focus on normative beliefs. The aim of this work is to define the theoretical model of the program, the contribution of the theories to the units, and the targeted mediators. The programme integrates several theories: Social Learning, Social Norms, Health Belief, theory of Reasoned Action-Attitude, and Problem Behaviour theory. Every theory contributes to the development of the units' contents, with specific weights. Knowledge, risk perception, attitudes towards drugs, normative beliefs, critical and creative thinking, relationship skills, communication skills, assertiveness, refusal skills, ability to manage emotions and to cope with stress, empathy, problem solving and decision making skills are the targeted mediators of the program
Correlates of alcohol experimentation and drunkenness episodes among secondary-school students in Nigeria
Full text linkBackground: Alcohol is the most used substance among adolescents in Nigeria. While risk factors for alcohol use among adolescents are well documented in Europe and the US, they have received less attention in the literature on African countries. This study aimed to investigate the factors associated with alcohol experimentation and drunkenness episodes in a national sample of Nigerian adolescents. Methods: A total sample of 4,078 secondary-school students participated in the survey during the school year 2015-2016. The survey involved 32 secondary schools of six geopolitical zones (South-South, South-West, South-East, North-Center, North-West, and North-East) and two metropolitan cities (Abuja and Lagos) of Nigeria. Sociodemographic characteristics, parental alcohol use and permissiveness, friends' alcohol use, risk perceptions and beliefs were investigated as correlates of alcohol experimentation and drunkenness episodes through multilevel, mixed-effect logistic regression models. Results: The prevalence of alcohol experimentation was 34.0%, while the prevalence of drunkenness episodes was 13.4%. Results showed that male gender, family structure different from both parents' families, parental and friends' alcohol use, parental permissiveness to drink, low risk perceptions on drinking alcohol, and positive beliefs on consequences of alcohol use were associated with an increased probability of alcohol experimentation and drunkenness episodes. Family affluence and one-parent family structure were related to an increased probability of alcohol experimentation but not of drunkenness episodes. Conclusions: The majority of risk factors analyzed in this study generalize across drinking-behavior outcomes. Since the young population is dominant in Nigeria, alcohol use could become a big public health problem in the near future. High investment in adolescents' well-being by addressing the factors that contribute to drinking behavior might help to reduce the burden of the problem. Evidence-based prevention curriculum addressing knowledge, risk perceptions, beliefs on consequences of alcohol use, and parental behaviors should be implemented as widely and early as possible
School-based prevention for illicit drugs' use
Full text linkBackground
Drug addiction is a chronic, relapsing disease. Primary interventions should be aimed to reduce first use, or prevent the transition from experimental use to addiction. School is the appropriate setting for preventive interventions.
Objectives
To evaluate the effectiveness of school‐based interventions in improving knowledge, developing skills, promoting change, and preventing or reducing drug use versus usual curricular activities or a different school‐based intervention .
Search methods
We searched the Cochrane Drug and Alcohol Group trial register (February 2004), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2004), MEDLINE (1966 to February 2004) , EMBASE (1988 to February 2004), and other databases. We also contacted researchers in the field and checked reference lists of articles.
Selection criteria
Randomised controlled trials (RCT), case controlled trials (CCT) or controlled prospective studies (CPS) evaluating school‐based interventions designed to prevent substance use.
Data collection and analysis
Two authors independently extracted data and assessed trial quality.
Main results
32 studies (29 RCTs and three CPSs) were included with 46539 participants. Twenty eight were conducted in the USA; most were focused on 6th‐7th grade students, and based on post‐test assessment.
RCTs
(1) Knowledge versus usual curricula
Knowledge focused programs improve drug knowledge (standardised mean difference (SMD) 0.91; 95% confidence interval (CI) 0.42 to 1.39).
(2) Skills versus usual curricula
Skills based interventions increase drug knowledge (weighted mean difference (WMD) 2.60; 95% CI 1.17 to 4.03), decision making skills (SMD 0.78; CI 95%: 0.46 to 1.09), self‐esteem (SMD 0.22; CI 95% 0.03 to 0.40), peer pressure resistance (relative risk (RR) 2.05; CI 95%: 1.24 to 3.42), drug use (RR 0.81; CI 95% 0.64 to 1.02), marijuana use (RR 0.82; CI 95% 0.73 to 0.92) and hard drug use (RR 0.45; CI 95% 0.24 to 0.85).
(3) Skills versus knowledge
No differences are evident.
(4) Skills versus affective
Skills‐based interventions are only better than affective ones in self‐efficacy (WMD 1.90; CI 95%: 0.25 to 3.55).
Results from CPSs
No statistically significant results emerge from CPSs.
Authors' conclusions
Skills based programs appear to be effective in deterring early‐stage drug use.
The replication of results with well designed, long term randomised trials, and the evaluation of single components of intervention (peer, parents, booster sessions) are the priorities for research. All new studies should control for cluster effect
Knowledge, attitudes and behaviours on tobacco, alcohol and drugs among Nigerian secondary school students: differences by geopolitical zones
Full text linkIntroduction and Aims. Nigeria is composed of six geopolitical zones plus one Federal Capital Territory. Differences between zones can differentially influence the adoption of risk behaviours by adolescents. This paper aims to describe the knowledge, attitudes, beliefs, risk perception, skills and substance use among Nigerian secondary school students highlighting the differences by geopolitical zone.
Design and Methods. The population size of each zone was taken into account in extracting the 32 schools for the survey. The characteristics of the social environment, tobacco, alcohol and substance use, knowledge, beliefs, risk perception, attitudes, personal skills and school climate were investigated through an anonymous questionnaire.
Results. A total of 4078 adolescents participated in the survey: 5.1% reported they had smoked cigarettes at least once in their life, 33.6% drank alcohol, 13.1% experienced drunkenness, 7.5% used cannabis and 11.6% other drugs. The highest rates of alcohol use were observed in the South, whilst the use of tobacco, cannabis and other drugs was higher in the North. Knowledge about tobacco, alcohol and marijuana was quite low across all zones. Scores for self-esteem, decision-making and refusal skills, risk perception and beliefs were lower in the North.
Discussion and Conclusions. This study shows a high prevalence of adolescent alcohol and substance use in Nigeria. There is a need for planning and implementing evidence-based drug education and prevention programs across the country. Prevention activities targeting adolescents could help to reduce the later life burden of disease related to use of tobacco, alcohol and other drugs
"Unplugged," a European school-based program for substance use prevention among adolescents: overview of results from the EU-Dap trial.
No full textThe EU-Dap study aimed to develop and evaluate a school-based curriculum for the prevention of substance use among young people. The school curriculum, "Unplugged," is based on social influence approach and addresses social and personal skills, knowledge, and normative beliefs. It consists of 12 one-hour interactive sessions delivered by teachers. Its effectiveness was evaluated through a randomized trial involving 7,079 pupils of seven European countries. Unplugged was effective in reducing cigarette smoking, episodes of drunkenness, and the use of cannabis at short term. This association, however, was confined to boys, with age and self-esteem as possible explanations of this difference. Beneficial effects associated with the program persisted at fifteen-month follow-up for drunkenness, alcohol-related problems, and cannabis use, and were stronger among adolescents in schools of average low socioeconomic level. These results are of scientific importance and may inform the adoption of effective public health interventions at population level
Prevalence of cocaine use and cocaine use disorder among adult patients with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis
No full textWe conducted this systematic review and meta-analysis (registered with PROSPERO CRD42020142039) of the literature to estimate the lifetime prevalence of cocaine use and cocaine use disorder among adult patients with attention-deficit/hyperactivity disorder (ADHD). The literature search was performed on the electronic databases PubMed and PsychINFO without date or language restrictions. Additional studies were identified by hand searching of citations. Inclusion criteria were: studies involving adult patients with ADHD and reporting cocaine use and/or cocaine use disorders. Data were pooled in the meta-analyses using a generalized linear mixed model with random effects. Statistical heterogeneity was assessed using the Cochran Q test. Sensitivity analyses were conducted. Twelve studies were included in the review: six in the meta-analysis of cocaine use and nine in the meta-analysis of cocaine use disorder. The estimated prevalence of cocaine use was 26.0% (95% CI 0.18–0.35) and the estimated prevalence of cocaine use disorder was 10.0% (95% CI 0.08–0.13). Heterogeneity in both meta-analyses was high but decreased to non-significance in the meta-analysis on cocaine use disorder after excluding the outlier study. In conclusion, one out of four adult patients with ADHD use cocaine and one out of ten develop a lifetime cocaine use disorder. Since cocaine use can lead to more severe and complex disorders of impaired systemic functioning, adult patients with ADHD should be assessed for cocaine use disorder and promptly referred for treatment
Opioid overdose risk during and after drug treatment for heroin dependence: An incidence density case–control study nested in the VEdeTTE cohort
Full text linkA follow-up study of heroin addicts (VEdeTTE2): study design and protocol
Full text linkAbstract Background In Italy, a large cohort study (VEdeTTE1) was conducted between 1998–2001 to evaluate the effectiveness of treatments in reducing mortality and increasing treatment retention among heroin addicts. The follow-up of this cohort (VEdeTTE2) was designed to evaluate the effectiveness of treatments on long-term outcomes, such as rehabilitation and social re-integration. The purpose of this paper is to describe the protocol of the VEdeTTE2 study, and to present the results of the pilot study carried out to assess the feasibility of the study and to improve study procedures. Methods The source population for the VEdeTTE2 study was the VEdeTTE1 cohort, from which a sample of 2,200 patients, traced two or more years after enrolment in the cohort, were asked to participate. An interview investigates drug use; overdose; family and social re-integration. Illegal activity are investigated separately in a questionnaire completed by the patient. Patients are also asked to provide a hair sample to test for heroin and cocaine use. Information on treatments and HIV, HBV and HCV morbidity are obtained from clinical records. A pilot phase was planned and carried out on 60 patients. Results The results of the pilot phase pointed out the validity of the procedures designed to limit attrition: the number of traced subjects was satisfactory (88%). Moreover, the pilot phase was very useful in identifying possible causes of delays and attrition, and flaws in the instruments. Improvements to the procedures and the instruments were subsequently implemented. Sensitivity of the biological test was quite good for heroin (78%) but lower for cocaine (42.3%), highlighting the need to obtain a hair sample from all patients. Conclusion In drug addiction research, studies investigating health status and social re-integration of subjects at long-term follow-up are lacking. The VEdeTTE2 study aims to investigate these outcomes at long-term follow-up. Results of the pilot phase underline the importance of the pilot phase when planning a follow-up study.</p
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